Overview of the cholinergic contribution to gait, balance and falls in Parkinson's disease

Rosie Morris, Douglas N. Martini, Tara Madhyastha, Valerie E. Kelly, Thomas J. Grabowski, John Nutt, Fay Horak

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Mobility deficits, including gait disturbance, balance impairments and falls, are common features of Parkinson's disease (PD) that negatively impact quality of life. Mobility deficits respond poorly to dopaminergic medications, indicating a role for additional neurotransmitters. Due to the critical role of cortical input to gait and balance, acetylcholine—an essential neurotransmitter system for attention—has become an area of interest for mobility. This review aimed to identify the role of cholinergic function on gait, balance, and falls in PD using three techniques; pharmacological, imaging, and electrophysiological. Studies supported the role of the cholinergic system for mobility in PD, with the most promising evidence indicating a role in falls. Imaging studies demonstrated involvement of anterior cholinergic (basal forebrain) systems in gait, and posterior (brainstem) systems in balance. However, this review identified a small number of studies which used varying protocols, making comparisons difficult. Further studies are warranted, measuring comprehensive gait and balance characteristics as well as gold standard falls detection to further quantify the relationship between ACh and mobility in PD.

Original languageEnglish (US)
JournalParkinsonism and Related Disorders
DOIs
StatePublished - Jan 1 2019

Fingerprint

Gait
Cholinergic Agents
Parkinson Disease
Neurotransmitter Agents
Brain Stem
Quality of Life
Pharmacology

Keywords

  • Acetylcholine
  • Balance
  • Falls
  • Gait
  • Parkinson's disease

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

Cite this

Overview of the cholinergic contribution to gait, balance and falls in Parkinson's disease. / Morris, Rosie; Martini, Douglas N.; Madhyastha, Tara; Kelly, Valerie E.; Grabowski, Thomas J.; Nutt, John; Horak, Fay.

In: Parkinsonism and Related Disorders, 01.01.2019.

Research output: Contribution to journalReview article

Morris, Rosie ; Martini, Douglas N. ; Madhyastha, Tara ; Kelly, Valerie E. ; Grabowski, Thomas J. ; Nutt, John ; Horak, Fay. / Overview of the cholinergic contribution to gait, balance and falls in Parkinson's disease. In: Parkinsonism and Related Disorders. 2019.
@article{a2a5dcabe9e748c1bf9ed446312441cf,
title = "Overview of the cholinergic contribution to gait, balance and falls in Parkinson's disease",
abstract = "Mobility deficits, including gait disturbance, balance impairments and falls, are common features of Parkinson's disease (PD) that negatively impact quality of life. Mobility deficits respond poorly to dopaminergic medications, indicating a role for additional neurotransmitters. Due to the critical role of cortical input to gait and balance, acetylcholine—an essential neurotransmitter system for attention—has become an area of interest for mobility. This review aimed to identify the role of cholinergic function on gait, balance, and falls in PD using three techniques; pharmacological, imaging, and electrophysiological. Studies supported the role of the cholinergic system for mobility in PD, with the most promising evidence indicating a role in falls. Imaging studies demonstrated involvement of anterior cholinergic (basal forebrain) systems in gait, and posterior (brainstem) systems in balance. However, this review identified a small number of studies which used varying protocols, making comparisons difficult. Further studies are warranted, measuring comprehensive gait and balance characteristics as well as gold standard falls detection to further quantify the relationship between ACh and mobility in PD.",
keywords = "Acetylcholine, Balance, Falls, Gait, Parkinson's disease",
author = "Rosie Morris and Martini, {Douglas N.} and Tara Madhyastha and Kelly, {Valerie E.} and Grabowski, {Thomas J.} and John Nutt and Fay Horak",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.parkreldis.2019.02.017",
language = "English (US)",
journal = "Parkinsonism and Related Disorders",
issn = "1353-8020",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Overview of the cholinergic contribution to gait, balance and falls in Parkinson's disease

AU - Morris, Rosie

AU - Martini, Douglas N.

AU - Madhyastha, Tara

AU - Kelly, Valerie E.

AU - Grabowski, Thomas J.

AU - Nutt, John

AU - Horak, Fay

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Mobility deficits, including gait disturbance, balance impairments and falls, are common features of Parkinson's disease (PD) that negatively impact quality of life. Mobility deficits respond poorly to dopaminergic medications, indicating a role for additional neurotransmitters. Due to the critical role of cortical input to gait and balance, acetylcholine—an essential neurotransmitter system for attention—has become an area of interest for mobility. This review aimed to identify the role of cholinergic function on gait, balance, and falls in PD using three techniques; pharmacological, imaging, and electrophysiological. Studies supported the role of the cholinergic system for mobility in PD, with the most promising evidence indicating a role in falls. Imaging studies demonstrated involvement of anterior cholinergic (basal forebrain) systems in gait, and posterior (brainstem) systems in balance. However, this review identified a small number of studies which used varying protocols, making comparisons difficult. Further studies are warranted, measuring comprehensive gait and balance characteristics as well as gold standard falls detection to further quantify the relationship between ACh and mobility in PD.

AB - Mobility deficits, including gait disturbance, balance impairments and falls, are common features of Parkinson's disease (PD) that negatively impact quality of life. Mobility deficits respond poorly to dopaminergic medications, indicating a role for additional neurotransmitters. Due to the critical role of cortical input to gait and balance, acetylcholine—an essential neurotransmitter system for attention—has become an area of interest for mobility. This review aimed to identify the role of cholinergic function on gait, balance, and falls in PD using three techniques; pharmacological, imaging, and electrophysiological. Studies supported the role of the cholinergic system for mobility in PD, with the most promising evidence indicating a role in falls. Imaging studies demonstrated involvement of anterior cholinergic (basal forebrain) systems in gait, and posterior (brainstem) systems in balance. However, this review identified a small number of studies which used varying protocols, making comparisons difficult. Further studies are warranted, measuring comprehensive gait and balance characteristics as well as gold standard falls detection to further quantify the relationship between ACh and mobility in PD.

KW - Acetylcholine

KW - Balance

KW - Falls

KW - Gait

KW - Parkinson's disease

UR - http://www.scopus.com/inward/record.url?scp=85061668814&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061668814&partnerID=8YFLogxK

U2 - 10.1016/j.parkreldis.2019.02.017

DO - 10.1016/j.parkreldis.2019.02.017

M3 - Review article

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

SN - 1353-8020

ER -